The CA Medical Treatment Utilization Schedule (7/18/09), ACOEM Practice Guidelines, 2nd Edition (2004), Chater 7 on Independent Medical Examinations and Consultations, (jpae 127), offers "The occupational health preactitioner may refer to other specialists if a diagnosis is uncertain or complex, whenpsychosocial factors are present, or when the plan or course of care may benefit from additional expertise". In addition ACOEM states on the same page a consultation is to aid in the diagnosis, prognosis, therapeutic management, determinatin of medical stability, and ermenent residulal and/or the examinee's fitness for return to work."

Use the above, sumbit a PR-2 to the CA/UR Dr for determination to medical necessity, and prior authorization of the referral.